Abstract

INTRODUCTION

Peritoneal dissemination may develop in many digestive system and gynecological cancers. Despite advances in imaging technologies, it is difficult to diagnose PC induced by digestive system tumors before surgery.

METHODS

In this study, staging tests used in patients with PC that unidentified preoperatively were reviewed retrospectively. Eighty-two patients were evaluated in between January 2012 and November 2015.

RESULTS

Forty-five (54.8%) patients had been operated with stomach cancer, 24 patients (29.2%) with colorectal, and 13 patients (15.8%), pancreas and biliary tract cancers. Computerized Tomography (CT) was taken to all patients for staging, 26 patients were also evaluated with abdominal ultrasonography (USG) and 4 patients with magnetic resonance imaging (MRI). Positron Emission Tomography (PET-CT) was applied to eight patients. While 40 (48.7%) patients underwent surgical bypass and other palliative procedures, no additional surgical procedures were performed in 42 patients. In our series of patients who all have undergone laparotomy, all patients were evaluated with preoperative CT and suspicious findings identified in 10 patients were interpreted as not being specific to quit laparotomy. The most suspicious findings were reported in PC patients with gastric cancer (8/45). In our study, the PET/CT findings of 4 out of 8 patients evaluated were interpreted as suspicious, but they were not strong enough to exclude PC.

DISCUSSION AND CONCLUSION

It is still difficult to diagnose PC before surgery with conventional radiological imaging techniques. Combined use of different imaging modalities together can increase the success rate. It should be known that the probability of PC is especially high in patients with tumor marker elevation and locally advanced and borderline resectable disease findings. If palliative interventions are not planned in these patients, staging laparoscopy emerges as a suitable alternative.